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In recent years sleep rhythm or chronotype have become one of the most studied subjects especially in psychology and educational environments. Chronotype is an important variable in interpersonal differences and it is related to psychological and physiological differences among people. There are three main chronotypes or eveningness, morningness preferences: morning, evening and composite. While a limited number of studies focused on the relationship between academic motivation and chronotype, no studies were found regarding the individuals in cognitive absorption with the internet and chronotype. In this study, the relationships among cognitive absorption, academic motivation, and chronotype were investigated and a study was conducted on a model regarding the intermediary role of chronotype. Positive relationship was found between morningness chronotype and academic motivation regarding the variables such as using information, self-transcendence and discovery. Positive relationship was determined between morningness chronotype and wonder and also the focus of attention variables of cognitive absorption; however, a negative relationship was determined between composite morningness chronotype and the factors of time and pleasure. It was determined that the chronotype the individual owns has an intermediary role between cognitive absorption and academic motivation.

The present study examined latent test anxiety profiles in a sample of 592 U.S. adolescents in grades 6-12 using latent profile analysis (LPA). The adolescents were administered a multidimensional measure of test anxiety in their schools. The results of LPA indicated that a three-profile test anxiety model provided the best fitting model. The three latent test anxiety subgroups were named low, medium, and high test anxiety. In addition, grade-level and gender were added as covariates to the model and LPA was performed again. Grade-level and gender were found to differentially predict membership in the latent test anxiety subgroups, with females more likely to be in the high latent test anxiety subgroup than in the medium and low latent test anxiety subgroups and middle school students were more likely to be in the high latent test anxiety subgroup than in the low latent test anxiety subgroup. Middle school students were also more likely to be in the medium latent test anxiety subgroup than in the low latent test anxiety subgroup. Implications for the development of measures, treatment, and prevention of test anxiety in the U.S. adolescent population are discussed.

Anatomy and physiology lectures, traditionally held face-to-face at Florida Gulf Coast University, moved overnight to an online environment during the COVID-19 pandemic. Reflecting back on our teaching experience, a few goals to successful Zoom-based teaching emerged: make meaningful connections with the students, stay connected with students by using questions during lectures, and enjoy this new connection throughout the semester and beyond. This article discusses one strategy employed to stay connected to students during virtual, Zoom-based teaching: the use of "Are you awake?" questions. The questions were written to guide students in their review of material just learned. We felt that this method resulted in scaffolding the students' experience, preventing unnecessary lecturing, and reducing Zoom-fatigue. By emphasizing a process of regularly "checking in" with the student, a further relationship was established between the course faculty and students as well as among the students. Anecdotal evidence of this question technique is shared, with student feedback being positive. Based on our experience, emotional presence in the online environment correlates to student success.

A unique approach to improving student success in Human Anatomy and Physiology can be centered around teaching the students about metacognitive learning strategies. This perspective discusses the implementation of a metacognitive learning strategies session and highlights some of the outcomes that resulted from the session through exam wrapper responses. A one-hour session discussing metacognitive learning strategies was presented for the students through a pre-recorded video with embedded participation questions. Topics included methods for changing student studying habits to be more efficient and to retain a deeper level of understanding of the material. The session was also accompanied by exam wrappers to help the students to apply the concepts from the session.

This narrative study tells the teaching and learning story of the recently retired Dr. Peggy LePage, a longtime member of the Human Anatomy and Physiology Society with a career as a community college anatomy and biology professor spanning nearly three decades. Drawn from a lengthy narrative interview, this paper describes Dr. LePage's background as a nontraditional student and explores her resilience as a woman in science, technology, engineering, and mathematics (STEM). When Dr. LePage neared a breaking point early in her career, an encounter with a well-known advocate for active learning in science classrooms transformed her pedagogy. She also became involved with HAPS and never looked back. Narrative passages from her interview emphasize Dr. LePage's persistence in STEM, her shift toward a teacher as learner mentality, and the benefits of learning communities for anatomy and physiology instructors.

Our institution underwent a curricular revision to change the course approach for introductory anatomy and physiology courses from separate, discipline-specific human anatomy and human physiology courses to an integrated A&P I and A&P II course approach. Through a mixed-methods exploratory study, this research sought to determine undergraduate student perceptions of anatomy through this curricular revision. Data was collected through word associations, open-ended surveys, and course evaluation data. Our results indicate that undergraduate student perceptions of anatomy changed between the first course and the second course in the sequence, rather than between course approaches. Students in both course approaches reported similar interests, confusions, and difficulties related to anatomy education, and an awareness of the explicit and implicit curriculum was evident in student responses. However, some specific evaluation prompts exhibited a significant difference between course approaches. Results from this perception study can guide practitioners to consider the curricular context and unique challenges of anatomy and physiology students in meeting the expectations of the health care field.

Community college students come from a variety of backgrounds and have different levels of educational preparedness compared to undergraduates in 4-year undergraduate schools. Historically, retention rates of these students in human physiology courses have been low, often due to non-passing grades. Incorporation of additional active learning techniques has the potential to benefit learning in this group, which might ultimately benefit retention. However, active learning activities need to be incorporated in a thoughtful manner, because some activities can increase anxiety in students, resulting in unintended consequences such as student withdrawal from such activities. This study introduced cooperative quizzes into community college human physiology classes to determine if they improved student exam performance and reduced student anxiety. The cooperative quizzes were intended to be given in face-to-face classes but were adapted for synchronous broadcast classes using Zoom due to the COVID-19 pandemic. In the sample of students studied, cooperative quizzes did not have a significant impact on exam grades. However, several students reported a preference for the cooperative quizzes over traditional quizzes. In addition, the intervention did not increase the reported anxiety scores among students, which adds support for the use of cooperative quizzes as an active learning strategy in STEM classes.

A challenge with large undergraduate classes is the provision of opportunities for students to construct educational documents and to obtain individualized feedback pertaining to their work. Being able to work as part of a group, to clearly express information both orally and in writing, and to self-reflect while providing constructive feedback are soft skills that are valued by employers in the healthcare professions. We describe a two-part assignment in which students first worked in small groups to construct an informative newsletter pertaining to either the gut microbiome or one of four assigned fad diets and then evaluated a newsletter created by a group of their peers. Survey data revealed that most students found the assignments valuable learning exercises and that the opportunity to evaluate a newsletter created by their peers was welcomed. These assignments provide a way for students studying anatomy and physiology to reflect on what they have learned in class and, through self-directed research, apply their new knowledge in a way that will serve them well once out in the workplace.

Engagement of multiple learning modalities has been shown to promote learning. This study aimed to develop resources for anatomical sciences educators interested in adding additional teaching modalities into their repertoire. Three review sessions were created for the muscle anatomy unit of an undergraduate anatomy and physiology course, each designed to engage a different learning modality. The first session was a kinesthetic experience in which students were cued through a sequence of body positions similar to yoga poses with instruction of muscle anatomy relevant to each position. The second session was a tactile experience in which students were instructed how to shape clay into models of muscles and place them on a corresponding plastic skeleton. The third session was an audience-response question and answer (Q&A) session in which students responded to questions and received feedback about their performance. Each of the three review sessions was successfully implemented in a large undergraduate course with 445 total students. The authors encourage other anatomy educators to adapt these sessions for use in their own teaching.

Students from a variety of majors take human anatomy and physiology courses--usually because they are required for their program of study. Many students find anatomy and physiology classes academically challenging and institutions across the country report high failure and withdrawal rates for these courses. Although research has shown that several factors may contribute to poor student performance, this study focused on the relationship between a student's major and their perceptions about the course to investigate whether these data were reflective of student success rates. Survey data was collected from students in the first semester of a two-semester, systems-based human anatomy and physiology course sequence. While the results did not show a statistical difference in successful completion of the anatomy and physiology course related to academic major, interesting preferences regarding learning styles, study habits, and perceived difficulty of the course were found.

Ehrlichiosis ("Ehrlichia chaffeensis"), a bacterial infection transmitted by ticks, and its complications are examined here in a case-based learning approach. This case scenario describes a person who was bitten by a tick while farming and the complications they experienced. Students are presented with a patient case scenario that entails a detailed assessment of the patient's physical status, medical history, vital signs, laboratory values, and treatment methods so as to provide a complete picture of the pathophysiology of ehrlichiosis. This case scenario can be used to teach physiology or pathophysiology of infection and inflammation topics in clinical courses such as nursing, physician assistant, pharmacy, and other allied health programs.

The incorporation of mobile learning methods (iLearning) into human anatomy and physiology classrooms has been debated with regard to its effectiveness in higher education. This study aimed to understand how iLearning affects college-aged students' perception of learning and engagement in an introductory human anatomy and physiology course using a survey established by Rossing and coworkers (2012). Perceived learning was not significantly different from start to end of the semester while perceived engagement was significantly different in a negative direction. Mean scores were high for both dimensions at both time points which may have diminished meaningful interpretation. Nevertheless, the present study demonstrates that iLearning can be successfully implemented into higher education classroom settings while maintaining traditional classroom teaching and learning techniques.

It is hypothesized that creating case studies that are visually and kinesthetically interactive will encourage experiential and active learning, as well as enhance student engagement and a sense of enjoyment in learning. The case studies in this study were designed to incorporate reading, visual imagery, as well as auditory and hands-on activities for the students. Specifically, each question created has an experiential and/or active component as well as immediate electronic auto-feedback. It was expected that students would find the incorporated images, video clips, interactive websites, as well as hands-on plastic models appealing as well as helpful in their learning. Additionally, it was anticipated that the case studies would assist with remembering key aspects of pathophysiology for the final exam. The four case study topics focus on peptic ulcers, cardiovascular diseases, diabetes, and bone fractures coupled with osteoporosis and sciatica. In addition, each case study begins with reflective questions that are designed to add a metacognitive component to each lesson. Surveys were given after each case study to gauge student satisfaction. In addition, final exam questions responses were analyzed for signs of improvement.

Human physiology is a foundational course for future health practitioners. Previous research suggests case studies may improve students' critical thinking and comprehension, but little is known about how case studies affect student interest, motivation, and belonging. The current quasi-experiment investigates the impact of integrating case studies into an otherwise lecture-based human physiology course, compared to traditional lecture-based teaching. We hypothesized that case studies would improve all student outcomes, especially for students from underrepresented groups. Results showed that students in the case study section received higher overall grades and scores for related questions on three exams, combined higher level Bloom's questions on those exams, interest, motivation, and belonging to the course when compared to at least one, and in most cases both, of the comparison sections. We found few significant interactions between course section and student demographic groups, though improvements in final grades appear to be driven by improved grades for women.

Concerning the evolution of our mind, it is of core interest to understand how high-level cognitive functions are embedded within low-level cognitive functions. While the grounding of meaning units such as content words and sentence has been widely investigated, little is known about logical cognitive operations and their association with nonlinguistic cognition. However, recent theoretical claims have suggested that "the foundations of logical oppositions and negation may well be much more deeply rooted in the physiological structure of human cognition than is standardly assumed" (p. 227, Jaspers, 2012). The present study investigated potential candidates for such a grounding process by exploring the associations between basic "yes" versus "no" decisions and nonlinguistic features. In five preregistered experiments investigating the interplay between deciding "yes" or "no" and color, shape, and facial expressions, there was converging evidence for the intercoupling between the process of performing a "yes" (agreeing) or "no" (rejecting) decision and emotional faces (happy/sad), color (green/red), and also shape (round/square and soft/sharp). Potential mechanisms for such associations are discussed.

Background: Teachers' stress, affect and general occupational well-being influence their teaching and their students. However, how teachers' daily physiological stress and positive affect are related in the classroom is unknown. To reduce teachers' stress and enhance their positive affect, it is crucial to understand how occupational well-being relates to stress and affect. Aim: The aim of the study was to examine the relationships between teachers' daily physiological stress and positive affect in authentic classroom settings and the roles played by teachers' self-efficacy beliefs, perceptions of school climate and burnout symptoms in daily stress and affect. Sample: The sample consisted of 45 classroom teachers. Method: Daily physiological stress was assessed by measuring salivary cortisol levels three times in two days. Positive affect was reported by experience sampling at the same time that cortisol was collected. Questionnaires were used to assess self-efficacy beliefs, perceptions of school climate and burnout symptoms. Three-level modelling with random intercepts and slopes was used to analyse the relationships between daily stress and affect and the effect of teachers' general occupational well-being on stress and affect. Results: No relationships were evident between teachers' physiological stress and positive affect or between daily changes of stress and affect. Self-efficacy beliefs were related to lower stress and higher affect in the middle of the school day. Having sufficient school resources were related to higher positive affect. Teachers' burnout symptoms were associated with lower positive affect. Conclusions: We emphasize the potential for self-efficacy and perceptions of school resources as targets for intervening in teachers' stress and affect.

Background: Self-efficacy, or the beliefs learners hold about what they can do, develops largely from how learners perceive and interpret four main sources of information: mastery experiences, vicarious experiences, social persuasions and physiological and affective states. Although the relationship between these sources and self-efficacy is well-established, less is known about the factors that may influence how early adolescent learners perceive and interpret information from these sources. Aims: The purpose of this study was to investigate how the predisposition of perfectionism might predict how learners perceive efficacy-relevant information in the domain of math. Methods: Using a correlational design, this study considered whether perfectionism was associated with how middle school students (N = 1683) perceive information from the four hypothesized sources of self-efficacy. Participants completed a paper-based survey at two time points. Perfectionism was measured at Time 1. Self-efficacy and its sources were measured at Time 2. Structural equation modelling techniques were used to examine the relationship between factors. Results and Conclusions: Students who held themselves to high standards (i.e., greater self-oriented perfectionism) reported higher levels of mastery experiences, vicarious experiences, social messages and self-efficacy. Conversely, students who felt external pressure to be perfect (i.e., socially prescribed perfectionism) reported lower levels of mastery experiences, vicarious experiences and self-efficacy, as well as higher levels of negative physiological and affective states. The relationship between perfectionism and self-efficacy was partially mediated by students' perceptions of mastery. This study extends the current literature on the sources of math self-efficacy in early adolescence by showing how a predisposition like perfectionism is associated with how adolescent learners perceive and interpret efficacy-relevant information.

Analogical reasoning is an important type of cognition often used by experts across domains. Little research, however, has investigated how generating analogies can support college students' self-regulated learning (SRL) of biology. This study therefore evaluated a contextualized cognitive learning strategy intervention designed to teach students to generate analogies as a learning strategy to aid learning within a university biology course. Participants (n = 179) were taught how to generate analogies as a learning strategy to learn about plant and animal physiology. We hypothesized the quality of students' generated analogies would increase over time, and their analogical reasoning, knowledge of cognition (KOC; a component of metacognitive awareness), and course performance would be higher after intervention, controlling for associated pre-intervention values. Regression analyses and repeated-measures analysis of variance indicated a positive relationship between generated-analogy quality and analogical reasoning, and increased analogy quality after intervention. No change in reported KOC was observed, and analogy quality did not predict course performance. Findings extend understanding of strategies that can support college students' biology learning. Researchers and practitioners can leverage our approach to teaching analogies in their own research and classrooms to support students' SRL, analogical reasoning, and learning.

Among the various systems taught in the preclinical phases, the nervous system is more challenging to learn than other systems. In this report, a novel teaching methodology, "real-life scenario (RLS) blended teaching," is described and its effectiveness in facilitating inquisitive learning in undergraduate medical students is evaluated. This mixed-method study was conducted among three groups ("group 1," n = 83; "group 2," n = 85; and "group 3;" n = 79) of undergraduate medical students (18--20 yr) in the neurology and behavioral sciences module. RLS was presented to students in the form of demonstrations, role-plays, videos, and group activities. "Group 1" students underwent traditional teaching-learning sessions. "Group 2" students underwent RLS blended sessions and were provided with multiple miniassignments in a vignette format. "Group 3" students received RLS blended sessions, multiple miniassignments, peer discussions, multiple formative assessments, and facilitator feedback sessions. The student performances on different exams were compared in terms of their group, and their perceptions of RLS were documented. Students exposed to RLS sessions blended with multiple assignments, peer discussions, multiple formative assignments, and facilitator feedback sessions performed well in the final summative assessments (67.87%) compared with those exposed to RLS sessions and assignments (50.21%) or exposed to traditional teaching alone (50.34%). RLS sessions increased students' curiosity and motivated them to learn the subject well. RLS sessions stimulated student interest and facilitated their learning. RLS along with effective use of multiple assignments, formative assessments, and/or feedback sessions significantly improved student learning. This demonstrates the effectiveness of this active method in teaching various subjects with appropriate modifications.

The Faculty of Medicine at Mandume Ya Ndemufayo University began teaching in 2009, taking on the challenge of outcomes-based education and aiming to train qualified professionals according to the needs of the community. This article aims to describe and analyze how the teaching of physiology is organized in the medical program at this university. This is a descriptive study of the course pedagogical plan from 2009 to 2020. The results revealed that there is a correspondence between learning outcomes of the Physiology course, the competencies set out in the Profile of the Angolan Doctor, and internationally established sets of competencies. Some weaknesses were identified in relation to the development of skills, pedagogical methodology, and the evaluation process. The recent educational context of this medical school poses great challenges, which require the contextualization and periodic adjustment of its pedagogical plans.

This study assessed the impact of an "active learning" strategy employed alone or in combination with traditional lectures on the learning of mammalian physiology by undergraduate students. The study investigated the impact of three teaching strategies, namely (1) traditional lecture, (2) group discussion alone, and (3) combination of lecture and group discussion. For all strategies, students were given homework in a textbook and they completed written assignments before each session. Every student led the discussion of at least one assigned theme during each group session. The students had no access to the textbook or notes during group discussions. Four examinations (3 in-semester and a final) assessed the students' knowledge of fundamental concepts of physiology of specific organ systems. Part of the final examination reassessed knowledge of previously tested topics. The results show that the teaching modality employed to introduce physiology topics influenced students' learning. The average marginal effect of the lecture þ discussion modality (average improvement linked to lecture þ discussion strategy) on students' performance was 6.45% [95% confidence interval (CI[subscript 95]) (4.73, 8.16), P = 1.74 10[superscript -13]], and the average improvement associated with the discussion-only modality was 5.5% [CI[subscript 95] (3.84, 7.16), P = 7.84 10[superscript -11]]. On average, all class ranks performed better on materials covered under active learning settings than under lecture-only conditions. Moreover, students' performance under combined lecture and discussion conditions is predictive of their overall performance in the course. The results support the positive effect of student-centered learning and demonstrate the efficacy of a combination of lectures and group discussions on learning of physiology by nonmajor students.

During the course of undergraduate studies, physiology (and related STEM) majors should acquire a both broad and in-depth foundation in physiological knowledge along with a distinct range of transferable (professional) skills (e.g., critical thinking, communication skills, data analysis). Previously, through a consultative and iterative process with physiology educators, the Professional Skills Committee of the Physiology Majors Interest Group (PMIG) defined and refined a consensus list of professional skills that physiology majors should acquire during their program of study. Here we describe the development and beta testing of a convenient tool to enable physiology and physiology-related program educators to map these professional skills across their curricula. The tool, referred to as PS-MAP, uses the Qualtrics platform and allows programs to collect and organize data about whether students are provided the opportunity to learn and develop the defined professional skills during their undergraduate experience. The authors have made the PS-MAP tool freely available to educators and provide practical tips for its implementation. Use of the PS-MAP tool and the data collected can help programs identify curricular strengths and gaps as well as facilitate curricular discussions among educators within the program.

Increasingly, the curricula of many clinical programs have been restructured to an integrated model in which foundational sciences such as physiology, pathophysiology, and pharmacology are taught side by side with clinical reasoning. Case studies are an excellent pedagogical strategy for enhancing such integration, especially if such cases are authentic, that is, they include a broad range of information that could influence the individualization and optimization of patient care. However, authentic cases may be too advanced and thereby dissuade preclinical students. We offered an optional semester-long authentic pharmacotherapy case study to undergraduate students in an introductory pharmacology class in a liberal arts college in the United States Midwest and sought to know what might motivate students to complete this challenging task. Connection with and relevance of the case study were assessed with an anonymous survey. Open-ended questions were analyzed qualitatively. Exploratory factor analysis and nonmetric multidimensional scaling were employed to investigate underlying commonalities and patterns in the motivations for participating in and relating to the case study. Students were motivated more by the perceived relevance and transferability of knowledge acquired to their future career than by their current clinical technician jobs or their personal lives. Rather than causing an information overload and dissuading students, this complex pharmacotherapy case assignment harnessed preclinical students' experiences from cognate cocurricular activities, created numerous points of relevant engagement with instructional content, and therefore motivated students to deeper learning. New & Noteworthy: Early introduction to clinical reasoning is widely advocated. Case studies are frequently used to enhance integration of foundational sciences with clinical reasoning. Preclinical students may be overwhelmed by complex cases because of the higher-order cognitive tasks involved. We find that complex cases permit connection with students' own experiences and aspirations. These preclinical students were motivated to engage in such challenging academic work because of the perceived transferability of knowledge to their future careers.

The authentic teaching and learning approach introduces real-world scenarios into the classroom to better engage Generation Z students. Considering this, we introduced an authentic learning practical exercise (breakfast meal and glycemic variation) to undergraduate biology students at the University of La Reunion (France). Here, students were initially briefed regarding the practical and subsequently determined their baseline glucose values (glucometer). They then consumed 200 mL of fruit juice together with a pain au chocolat (chocolate pastry) and subsequently recorded their glucose values at regular intervals. The last reading was done after 150 min, and they thereafter plotted such data to reveal temporal glycemic variations. During this time, the students also worked on a report to document information collected and began to supply responses to several listed questions. Three weeks after completion of the practical, we evaluated whether this intervention would lead to changes in their views regarding the nature and regularity of breakfast meal intake (employing survey questions). Our findings show that a reasonable proportion of the students indicated that the intervention did change their dietary habits, with 50% sometimes opting for an improved breakfast, whereas 10% also changed their habits albeit for only a small while. Of note, >60% of students indicated that they changed their breakfast intake habits by the end of the endocrinology module. These findings show that the beneficial effects of authentic teaching approaches may elicit relatively long-lasting changes in terms of breakfast behavioral patterns in young people and that such effects may also impact the broader society. New & Noteworthy: This study introduced an authentic learning exercise (endocrinology practical exercise) to undergraduate biology students and ascertained whether it changed their views regarding the nature and regularity of breakfast meals. Here, many altered their breakfast dietary habits, which persisted even after the completion of their module. Authentic teaching approaches can therefore trigger relatively long-lasting changes in terms of breakfast behavioral patterns in young people and may also impact the broader society.

The current student body will, by and large, seek online resources to supplement their learning. However, resources that are freely available online vary in accuracy and quality, and the vast majority rely on passive learning. Therefore, there is a need for interactive physiology teaching resources that facilitate application of knowledge, that can be accessed by students in their own time. The aim of this study was to design a digital escape room on the topic of cardiac arrhythmias and to evaluate this resource as a consolidation exercise to support learning and enjoyment of physiology. The digital escape room was designed as a series of interactive puzzles and created with a website page builder on a freely accessible WordPress site. To facilitate engagement, the escape room incorporated a countdown timer. Second-year medical students were invited to play the digital escape room remotely as a group exercise after delivery of the relevant teaching. Evaluation of the resource took place quantitatively with Google Analytics and Tag Manager software and qualitatively with a questionnaire (Microsoft Forms). Quantitative evaluation suggested that the puzzles were created across a range of difficulties but that most groups were able to complete the exercise and remained engaged throughout. Student feedback suggests that the format of the resource was rated positively, and most participants felt that the game helped to consolidate and apply their knowledge of cardiovascular physiology. Future studies will focus on examining whether the cardiovascular-themed digital escape room improves knowledge attainment among students studying physiology in higher education.

Fetal androgen exposure may be associated with autism spectrum disorder (ASD). We studied 1777 mother-child pairs in the prospective Odense Child Cohort. Prenatal androgen exposure was assessed by maternal 3rd trimester testosterone concentrations, maternal polycystic ovary syndrome (PCOS), and 3 months offspring anogenital distance. ASD traits were assessed at age 3 years with the ASD-symptom scale of the Child Behavior Checklist for ages 1 1/2-5 years. Maternal testosterone was positively associated with traits of ASD in boys (p < 0.05). Maternal PCOS was associated with increased offspring ASD traits (p = 0.046), but became non-significant after excluding parental psychiatric diagnosis. Offspring anogenital distance was not linked to ASD traits. Higher prevalence of ASD in boys could be linked to higher susceptibility to fetal androgen exposure.

Interoception, the body's perception of its own internal states, is thought to be altered in autism, though results of empirical studies have been inconsistent. The current study systematically reviewed and meta-analyzed the extant literature comparing interoceptive outcomes between autistic (AUT) and neurotypical (NT) individuals, determining which domains of interoception demonstrate robust between-group differences. A three-level Bayesian meta-analysis compared heartbeat counting performance, heartbeat discrimination performance, heartbeat counting confidence ratings, and self-reported interoceptive attention between AUT and NT groups (15 studies; n[subscript AUT] = 467, n[subscript NT] = 478). Autistic participants showed significantly reduced heartbeat counting performance [g = - 0.333, CrI[subscript 95%] (- 0.535, - 0.138)] and higher confidence in their heartbeat counting abilities [g = 0.430, CrI[subscript 95%] (0.123, 0.750)], but groups were equivalent on other meta-analyzed outcomes. Implications for future interoception research in autism are discussed.

Purpose: Team-based learning (TBL) is an instructional design that has been increasingly used in anatomy and physiology education. The appropriateness of TBL methods for students with diverse preferred sensory learning modalities has not been adequately examined. This study aimed to show the influence of students' preferred sensory modality for learning on TBL outcomes. Method: Communication sciences and disorders majors enrolled in anatomy and physiology courses completed VARK (Visual, Aural, Read/write, and Kinesthetic), a questionnaire quantifying their preferred learning modality. Students' traditional and TBL measures of academic success were compared by preferred learning modality. Results: A multivariate analysis of variance failed to find any difference in TBL or other outcomes by preferred learning modality (p = 0.252). Conclusions: The results of this study show no evidence of differences in academic outcomes in TBL projects between learners with different preferred learning modalities as measured by VARK. The role of TBL and of instructional sensory modality on learning outcomes should continue to be examined.

Purpose: Muscle groups within the tongue in healthy and diseased populations show different behaviors during speech. Visualizing and quantifying strain patterns of these muscle groups during tongue motion can provide insights into tongue motor control and adaptive behaviors of a patient. Method: We present a pipeline to estimate the strain along the muscle fiber directions in the deforming tongue during speech production. A deep convolutional network estimates the crossing muscle fiber directions in the tongue using diffusion-weighted magnetic resonance imaging (MRI) data acquired at rest. A phase-based registration algorithm is used to estimate motion of the tongue muscles from tagged MRI acquired during speech. After transforming both muscle fiber directions and motion fields into a common atlas space, strain tensors are computed and projected onto the muscle fiber directions, forming so-called strains in the line of actions (SLAs) throughout the tongue. SLAs are then averaged over individual muscles that have been manually labeled in the atlas space using high-resolution T2-weighted MRI. Data were acquired, and this pipeline was run on a cohort of eight healthy controls and two glossectomy patients. Results: The crossing muscle fibers reconstructed by the deep network show orthogonal patterns. The strain analysis results demonstrate consistency of muscle behaviors among some healthy controls during speech production. The patients show irregular muscle patterns, and their tongue muscles tend to show more extension than the healthy controls. Conclusions: The study showed visual evidence of correlation between two muscle groups during speech production. Patients tend to have different strain patterns compared to the controls. Analysis of variations in muscle strains can potentially help develop treatment strategies in oral diseases.

Purpose: This research note illustrates the effects of video data with nonsquare pixels on the pixel-based measures obtained from videofluoroscopic swallow studies (VFSS). Method: Six pixel-based distance and area measures were obtained from two different videoflouroscopic study units; both yielding videos with nonsquare pixels with different pixel aspect ratios (PARs). The swallowing measures were obtained from the original VFSS videos and from the videos after their pixels were squared. Results: The results demonstrated significant multivariate effects both in video type (original vs. squared) and in the interaction between video type and sample (two video recordings of different patients, different PARs, and opposing tilt angles of the external reference). A wide range of variabilities was observed on the pixel-based measures between original and squared videos with the percent deviation ranging from 0.1% to 9.1% with the maximum effect size of 7.43. Conclusions: This research note demonstrates the effect of disregarding PAR to distance and area pixel-based parameters. In addition, we present a multilevel roadmap to prevent possible measurement errors that could occur. At the planning stage, the PAR of video source should be identified, and, at the analyses stage, video data should be prescaled prior to analysis with PAR-unaware software. No methodology in prior absolute or relative pixel-based studies reports adjustment to the PAR prior to measurements nor identify the PAR as a possible source of variation within the literature. Addressing PAR will improve the precision and stability of pixel-based VFSS findings and improve comparability within and across clinical and research settings.

There is growing interest among educational researchers in using heart rate variability (HRV) as an index of children's capacity to regulate their physiological arousal. Links between HRV and young children's self-regulation have, however, been inconsistent, and there is limited research on children's HRV in learning-related contexts. HRV was collected from 86 children aged 3.41 to 5.83 years before, during, and after they engaged in a learning interaction with an examiner. Higher HRV during a pre-learning episode and a larger drop in HRV during the learning interaction were associated with stronger behavioral performance on self-regulation and early academic skill assessments. Children's capacity to modulate their HRV in response to learning opportunities may be linked to their broader self-regulation and early academic skill development. Effects varied by episode and gender, underscoring a need for further research to rigorously evaluate the utility and generalizability of HRV in authentic educational settings.

In order to examine whether syntactic processing is a necessary prerequisite for semantic integration in Japanese, cortical activation was monitored while participants engaged in silent reading task. Congruous sentences (CON), semantic violation sentences (V-SEM), and syntactic violation sentences (V-SYN) were presented in the experiment. The participants' oxygenated hemoglobin concentration changes during the reading task were measured using functional near-infrared spectroscopy. The results suggest that the CON sentences did not require additional cognitive load on syntactic processing or semantic processing. The V-SEM sentences demanded great cognitive load on semantic processing. Besides, it also elicited great cognitive load on syntactic processing. The V-SYN sentences induced great cognitive load on syntactic processing, but it did not induce additional load on semantic processing. These evidence demonstrates that, in Japanese language processing, the difficultness of semantic processing could influence the difficultness of syntactic processing, while the difficultness of syntactic processing would not influence the difficultness of semantic processing. Our findings are suggestive of the possibility that in Japanese language reading, semantic processing precedes syntactic processing, or semantic processing and syntactic processing are in parallel.

We examined the relationship between weight status, appetite regulating hormones, and mealtime behaviors among children, (5-12 years old), diagnosed with Autism Spectrum Disorder (ASD) in a cross-sectional study. All (N = 21) completed anthropometry measurements and (n = 18) provided blood samples for hormone analysis. Mealtime behavior, dietary, physical activity, puberty stage, and social impairment data were collected. Under fasting conditions, overweight/obese (OWOB) participants, (n = 6), had higher leptin concentrations (p < 0.02) and more feeding challenges (p < 0.05) than normal weight (n = 15). Higher leptin levels and disruptions in mealtime behaviors may exist among OWOB children in this study. Future longitudinal studies that examine appetite regulating hormones and mealtime behaviors may inform our understanding of the role of these markers in the development of obesity in ASD.

Background: There is little research into experiences of menopause voiced by women with learning disabilities, who can be neglected in academic research. There is a particular lack of knowledge around the psychological and social experiences of menopause in this population, and how changes are managed. This study sought to explore these experiences. Methods: Experiences of five women with lived experience of menopause, being seen by community National Health Services specialising in learning disabilities, were captured with semistructured interviews and analysed using interpretive phenomenological analysis. Findings: Five superordinate themes were identified, involving the importance of having information about menopause, challenges of periods, observable changes in menopause, the importance of social connection, and managing menopause independently. Conclusions: This study highlights the need for clinicians and carers to understand the variety of impacts menopause can have on women with learning disabilities, including emotional and social aspects, and the need to initiate conversations regarding menopause and available treatments.

This study investigated the impact of gender on the sources of students' self-efficacy in Mathematics in Tanzanian secondary schools. Data were collected from 267 Form 3 (Grade 11) students sampled from three public secondary schools in Dar es Salaam region. A previously validated questionnaire scale was used for measuring the sources of students' self-efficacy in Mathematics: mastery experience, vicarious experience, physiological state (emotional arousal such as anxiety) and social persuasions. Data were analyzed using descriptive statistics, structural equation modeling and latent mean analysis techniques. Results from the structural equation modeling showed that the four-factor model best describes the sources of students' self-efficacy in Mathematics. Results from descriptive statistics showed that students positively considered vicarious experience, mastery experience and social persuasions as credible sources of their self-efficacy in Mathematics. Results from the latent mean analysis showed significant gender differences in students' perception of mastery experience. Meanwhile, vicarious experience and mastery experience positively predicted students' Mathematics performance while physiological state was a negative predictor. The results imply that intervention for improving Mathematics learning ought to focus on fostering students' sources of self-efficacy, particularly reducing psychological states that lower students' self-efficacy in Mathematics.

This study was designed as a prospective, randomized controlled trial. A total of 90 preterm infants who underwent retinopathy of prematurity (ROP) examinations were categorized into three groups, a control group, a white noise group (WN), and a classical music group (CM), each comprising 30 preterm infants. The study data were obtained using an information form and the Premature Infant Pain Profile. During (WN: 9.70±3.02; CM: 11.2±2.28) and after the examination (WN: 3.60±2.11; CM: 3.77±1.83), the preterm infants in the WN and CM groups had lower mean pain scores and heart rates (181.17±15.76 and 3150.10±17.03 vs. 173.30±20.66 and 146.67±18.17, respectively; p<0.001) and higher mean oxygen saturation values (93.60±3.87 and 97.83±1.93 vs. 95.73±2.52 and 98.27±1.82, respectively; p<0.05) than those in the control group; the differences were statistically significant. The WN and CM listened to by the preterm infants during ROP examinations had positive effects on pain and heart rate and oxygen saturation values.

Learning to write is a complex process involving linguistic, cognitive, and socio-emotional factors. From a developmental perspective, little research has explored the content of young children's writings in terms of specific cognitive skills such as Theory of Mind (TOM). This study explores how young children's writing may foster representations of inner life, their own and others, through the characters created and through an awareness of the reader's perspective. A total of 204 written compositions were gathered throughout one school year from 24 6-to-7-year-olds. The results indicate that while tackling the complexity of word and sentence composition, significant cognitive resources are allocated to the content of the stories, the characters' experiences but also the reader's understanding of the plots created. The findings offer important implications for supporting children's TOM through early fiction writing and highlight the importance of naturalistic data in uncovering young children's growing insights about others' thoughts and emotions.

Background: Dysphagia is prevalent in subjects with Parkinson's disease (PD). Swallowing intervention to improve or maintain swallowing function is of major importance as dysphagia may considerably impact physical and psycho-social health. Aims: A mixed methods systematic review was conducted to summarize and appraise literature reporting (1) effects of behavioural interventions for swallowing in individuals with PD; and (2) participants' perspectives of swallowing interventions. Methods & Procedures: Electronic databases were searched systematically in July 2020 for articles published between 2014 and 2020. In addition, studies published between 2000 and 2014 were identified non-systematically through previous reviews. Peer-reviewed quantitative and qualitative research in English or German documenting behavioural interventions for swallowing in individuals with a diagnosis of PD was eligible for inclusion. Participants at all disease stages were included. Behavioural interventions included rehabilitative and compensatory strategies. Studies reporting swallowing outcomes with and without a comparative group were included. For each study, the National Health and Medical Research Council level of evidence was defined. Included studies were critically appraised using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields. An integrated synthesis was performed after separate analysis of effect data and data reflecting participants' experiences. This review was conducted based on published JBI methodology and the guideline from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis system was followed. Main Contribution: A total of 33 studies published in English met the inclusion criteria. Thirty-one studies reported quantitative data, one was qualitative and one was mixed methods. Intervention effects on swallowing function, swallowing safety and swallowing-related quality of life were reported for various treatment approaches. Three studies explored how participants perceived the intervention. Overriding themes including subjects' views regarding treatment schedules and levels of effort or comfort associated with the intervention were identified across these studies. Combining evidence of intervention effects and subjects' experiences was possible for one rehabilitative and one compensatory intervention. Conclusions & Implications: Beneficial effects of swallowing interventions have been reported; however, most experiments were case studies of variable methodological quality. Randomized-controlled trials with robust methodology to explore treatment effects in larger samples is needed to guide clinical practice. Research reporting subjects' views is scarce. More studies exploring how individuals perceive behavioural interventions for swallowing are necessary to inform clinical decision-making.

During the pandemic, the use of question pools for online testing was recommended to mitigate cheating, exposing multitudes of science, technology, engineering, and mathematics (STEM) students across the globe to this practice. Yet instructors may be unfamiliar with the ways that seemingly small changes between questions in a pool can expose differences in student understanding. In this study, we undertook an investigation of student performance on our questions in online exam pools across several STEM courses: upper-level physiology, general chemistry, and introductory physics. We found that the difficulty of creating analogous questions in a pool varied by question type, with quantitative problems being the easiest to vary without altering average student performance. However, when instructors created pools by rearranging aspects of a question, posing opposite counterparts of concepts, or formulating questions to assess the same learning objective, we sometimes discovered student learning differences between seemingly closely related ideas, illustrating the challenge of our own expert blind spot. We provide suggestions for how instructors can improve the equity of question pools, such as being cautious in how many variables one changes in a specific pool and "test driving" proposed questions in lower-stakes assessments.

Vitamin A deficiency (VAD) may cause anemia. The research aimed at evaluating the effect of Vitamin A supplementation (VAS) on hemoglobin (Hb) is, however, limited and, conclusions drawn from a few studies have been concluded inconsistently. In Bangladesh, the prevalence of childhood anemia is high, as well as the prevalence of VAD. Therefore, the purpose of this study was to assess the effect of single high dose VAS on Hb of 6-59 months aged children in Bangladesh. A total of 2,058 children was extracted from the 2011 Bangladesh Demographic Health Survey (BDHS), who received a single dose of VAS in the preceding 6 months. Propensity score matching (PSM) was used by carefully incorporating the survey design to make causal inferences based on this nationally representative survey data. Results show that in sociodemographic variables, VA supplemented and non-supplemented groups were homogeneous. According to PSM, VAS was not significantly related to child Hb status. Stratified analysis based on household wealth status indicates that wealth status was not changing this relationship. Single high dose of VAS alone was not improved child Hb status in Bangladesh. Accordingly, there is a need to strengthen the food fortification program, enhance dietary diversity, increase nutritional education and awareness. Furthermore, future research is needed to comprehend the complex pathways.

Historically sleep was considered a passive activity, but research now strongly suggests that it is a time of neurological growth, where memories and skills are consolidated (Fallone et al., 2002). Good sleep is thought to influence cognitive, physical and emotional performance, and aid in effective emotional regulation (Alfano & Gamble, 2009). Whilst sleep problems are relatively common amongst children and adolescents, with estimates varying between 11% and 47% (Russo et al., 2007), they are significantly more common in those with Autism (30% to 80%, Goldman et al. 2012; Hirata et al. 2016; Krakowiak et al. 2008). Research also suggests that without intervention these problems are likely to persist (Goldman et al. 2012; Hodge et al. 2013). Emerging research finds that autistic children and adolescents experience specific sleep difficulties that are unique to this group. As research on the etiology of sleep problems in autism develops we are refining our approaches to intervention to more effectively meet the needs of these children and young people and their families. This article summarises current research into the specific sleep needs of this group. It also considers the multifactorial etiology of sleep problems for this group, and evidence based interventions to date. The author argues that through increased awareness, professionals can do much to ameliorate challenges related to sleep, and improve family functioning and quality of life.

Objective: Investigate whether psychosocial risk in the childhood family environment moderates the relationship between childhood socioeconomic status (SES) and sleep, and the relationship between childhood SES and ambulatory blood pressure (ABP) in college students, two factors that are linked to future risk for cardiovascular disease. Participants: 124 American college students. Methods: Childhood SES and psychosocial risk in childhood family environments were measured by self-report instruments. Sleep was measured with self-report and actigraphy (over 5 days) and ABP over a 2-day period. Results: Linear regressions adjusting for age, sex, current SES, and current depressive symptoms indicated that SES and psychosocial risk in family environments during childhood interact to inform sleep quality, actigraphy derived wake after sleep onset (WASO), actigraphy derived Sleep Efficiency (SE) and ABP. Conclusions: Psychosocial risk in the childhood family environment may offset previously documented relationships between childhood SES and health-relevant outcomes in college students.

Objective: The role of simultaneous alcohol and marijuana (SAM) use in the experience of blackouts among college students is unclear. To clarify discrepancies, the current study evaluated whether the association between SAM user status and blackouts was moderated by high-intensity drinking (HID). Participants and Methods: College students (N = 1,224; 63.7% female) reported on their past year experiences of blackout, marijuana use, SAM use, and HID (i.e., drinking at least twice the binge threshold). Results: SAM users had more past year blackouts than non-SAM users, but this effect was only significant among SAM users who had engaged in HID in the past year (nonbinge: F[subscript (5,37)] = 0.50, p = 0.49; binge: F[subscript (5,138)] = 0.23, p = 0.63; HID: F[subscript (5,328)] = 4.52, p = 0.03). Conclusions: Effects of SAM user status on the experience of alcohol-related blackouts may be limited to individuals who engage in HID.

The present study examined the effects of decorative pictures (DP) on cognitive load during learning factual knowledge from texts assessed by physiological proxies, namely pupil dilation and the electroencephalogram (EEG) theta (4-6 Hz) and alpha (8-13 Hz) frequency band power at frontal and parietal electrodes, respectively. In a complete within-subjects design the presence of DP positioned beside learning texts and the emotional content of the DP (i.e., negative, neutral, and positive DP) were manipulated. For DP present, pupil dilation and the EEG alpha frequency band power indicated increased cognitive load, specifically for negative DP. Behavioral performance measures (i.e., learning times and learning outcomes) were not affected by the presence of DP. Subjective effort ratings were also not affected by DP, although specifically the negative DP were subjectively perceived as distracting. In sum, DP only moderately affected cognitive load allowing subjects to compensate.

In this paper, we describe a dynamic-model as a strategy to teach DNA transcription and translation in an active way. This activity aims to provide learning beyond memorisation through the simulation of molecular processes, stimulating the elaboration of questions and hypotheses by students. The dynamic consists of four steps, starting with different problem situations which provide a context and encouragement to start the activity. The next steps connect these problems with DNA transcription and translation, requiring the active participation of students to simulate these processes through a construction of a model based on an iron board and representations of cellular structures, enzymes and genetic sequences fixed in magnets. An implementation experience of this dynamic, applied to 21 undergraduate veterinary students at a public university in the city of Curitiba, Paraná State, Brazil, is also described. Data from pre and post-questionnaires suggest knowledge about DNA transcription and translation was improved and some previous mistakes were clarified. Among the positive aspects that were cited by the students, the words visualisation and playful were more frequent, which reflect the didactic aspects of the dynamic. Some points of attention are discussed throughout the paper, as well as educational implications associated with the material and its potential to promote active learning.

Objective: Childhood maltreatment (CM) is associated with physical health problems throughout the lifespan, yet more research is needed regarding the trajectory of health problems (e.g., onset of health risk indicators) in young adults. The current study examined whether college students self-reporting higher levels of CM exhibited poorer physical health outcomes. Method: Young adults in college (N = 100) completed a physical health assessment (heart rate, body mass index (BMI), blood pressure, blood sugar, waist circumference), self-reported measures of health (symptoms of illness), and CM during spring semester 2018. Results: CM scores predicted higher heart rate and increased symptoms of illness. Females with maltreatment history presented higher levels of obesity and more metabolic syndrome conditions than their peers. Conclusions: Findings support the importance of examining the trajectory of CM to chronic disease, as health risk indicators are present in young adults.

Objective: College students make many important decisions related to sexual health, but little is known about their reproductive health knowledge. The purpose of the study was to examine health literacy and knowledge of female reproduction, contraception, and sexually transmitted infections (STIs) in college students. Participants: Undergraduate students (n = 323) completed a survey in November 2017. Methods: The survey included the Newest Vital Sign (NVS), Knowledge of the Female Body (KFB) scale, contraceptive questions, STI prevention questions, and sexual history questions. Results: NVS and KFB scores were positively correlated (p < 0.01). Male participants demonstrated significantly lower KFB scores than female participants (p < 0.001). Transgender participants demonstrated lower health literacy and lower knowledge of basic female reproduction than cisgender participants. Participants demonstrated low knowledge of the menstrual cycle, early physical signs of pregnancy, and certain contraceptives. Conclusions: Undergraduate students have major reproductive knowledge gaps. Healthcare providers need to consider health literacy and knowledge level when educating college students.

Internet-based platforms present vital new venues for sex education. However, research is limited on the ways adolescents utilize these resources, particularly within user-generated content contexts. This study assesses the sexual health content adolescents seek online through a qualitative, directed content analysis of 365 user-generated posts in an open sexual health community forum. An adapted version of the National Sex Education Standards, a comprehensive, evidence-based sexual health framework, was used as the schema for this data analysis. Collectively, our results highlight and confirm the importance of providing comprehensive, medically accurate sexual health information to adolescents. Our analysis further supports the need to provide information on pleasure in sexual health and well-being, as well as guidance on social and emotional aspects of sexual health, and for education to be supportive and inclusive of all individuals. Ultimately, our results can help guide effective public health interventions, including sex education efforts, aimed at promotion of adolescent sexual health by offering direct insight into adolescents' perceived information needs.